Safe Use of Long-Acting Opioids

British Columbia Specific Information

All opioids, including prescribed medications such as morphine and oxycodone, can be addictive. If you are concerned about your use of opioids, speak with your health care provider. For more information visit HeretoHelp.

Individual, family and small group counselling is available to people of all ages who are directly or indirectly affected by alcohol and other drug use. For more information call the 24-hour BC Alcohol and Drug Information and Referral Service in the Lower Mainland at 604-660-9382 or toll-free anywhere in B.C. at 1-800-663-1441, or visit our Mental Health and Substance Use web pages.

To find mental health and substance use support services in your area, search the HealthLinkBC Directory or contact your local health authority.

Overview

Opioids are strong medicines. They can help you manage pain when you use them the right way. But they can cause serious harm and even death.

If you decide to take opioids, here are some things to remember.

Keep your doctor informed.: You can develop opioid use disorder. Moderate to severe opioid use disorder is sometimes called addiction. The risk is higher if you have a history of substance use. Your doctor will monitor you closely for signs of opioid use disorder and to figure out when you no longer need to take opioids.
Make a treatment plan.: The goal of your plan is to be able to function and do the things you need to do, even if you still have some pain. You might be able to manage your pain with other non-opioid options. These include cognitive behavioural therapy (CBT), physiotherapy, relaxation, non-opioid prescription pain medicine, and over-the-counter pain medicines.
Be aware of the side effects.: Opioids can cause side effects, such as constipation, sleepiness, and nausea. And over time, you may need a higher dose to get pain relief. This is called tolerance. Your body also gets used to opioids. This is called physical dependence. If you suddenly stop taking them, you may have withdrawal symptoms. Serious risks of using opioids include overdose and death.

Safety tips when using long-acting opioids

If you need to take opioids to manage your pain, remember these safety tips.

Follow directions carefully.

It's easy to misuse opioids if you take a dose other than what's prescribed by your doctor. This can lead to accidental overdose and even death. Even sharing them with someone they weren't meant for is misuse.

Be cautious.

Opioids may affect your judgment and decision making. Do not drive or operate machinery while you take them. Talk with your doctor or pharmacist about when it is safe to drive.

Reduce the risk of drug interactions.

Opioids can be dangerous if you take them with alcohol or with certain drugs like sleeping pills and muscle relaxers. The combination can decrease your breathing rate and lead to overdose or death. Make sure your doctor knows about all the other medicines you take, including over-the-counter medicines and natural health products. Don't start any new medicines before you talk to your doctor or pharmacist.

Safely store and dispose of opioids.

Store opioids in a safe and secure place. Make sure that pets, children, friends, and family can't get to them. When you're done using opioids, make sure to dispose of them safely and as quickly as possible. Do not keep your opioid medicine or opioid patches for later use.

Health Canada recommends that you take your opioid pills and patches to a pharmacy or take-back program.

If you can't get to a pharmacy or a take-back program, you can dispose of them in your household trash using these steps.

Take the medicine out of its container.
Mix it with something that tastes bad, such as cat litter or coffee grounds.
Place the mixture in a sealed plastic bag, and put the bag in your household trash.

Do not flush your medicine down the toilet or sink.

Take special care with used opioid patches. As soon as you peel a patch off of your skin, fold it in half with the sticky sides together. Immediately take it to the pharmacy to safely get rid of it. Do not throw it in the trash.

Reduce the risk of overdose.

Opioids can be very dangerous. Protect yourself by asking your doctor or pharmacist about a take-home naloxone kit. It can help you—and even save your life—if you take too much of an opioid. You can get naloxone without a prescription at most drugstores or through a community Take Home Naloxone program.

What are some examples of long-acting opioids?

Fentanyl patch
Methadone
Morphine sulfate
Oxycodone controlled-release

What are the side effects?

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine

The risk of overdose and misuse is higher with long-acting opioids.

Common side effects of this medicine include:

Constipation.
Dizziness, light-headedness, or feeling faint.
Drowsiness.
Nausea or vomiting.

Here are some important things to think about:

Usually the benefits of the medicine are more important than any minor side effects.
Side effects may go away after you take the medicine for a while.
If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 9-1-1 or your local emergency service right away if you have:

Trouble breathing.
Swelling of your face, lips, tongue, or throat.
Signs of an overdose, including:
- Cold, clammy skin.
- Confusion.
- Severe nervousness or restlessness.
- Severe dizziness, drowsiness, or weakness.
- Slow breathing.
- Seizures.

Call your doctor if you have: